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Cor pulmonale
Right-sided heart failure; Pulmonary heart disease
Cor pulmonale is a condition that causes the right side of the heart to fail. Long-term high blood pressure in the arteries of the lung and right ventricle of the heart can lead to cor pulmonale.
Causes
High blood pressure in the arteries of the lungs is called pulmonary hypertension . It is the most common cause of cor pulmonale.
High blood pressure
Blood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...
Pulmonary hypertension
Pulmonary hypertension is high blood pressure in the arteries of the lungs. It makes the right side of the heart work harder than normal.
In people who have pulmonary hypertension, changes in the small blood vessels inside the lungs can lead to increased blood pressure in the right side of the heart. This makes it harder for the heart to pump blood to the lungs. If this high pressure continues, it puts a strain on the right side of the heart. That strain can cause cor pulmonale.
Lung conditions that cause a low blood oxygen level in the blood over a long time can also lead to cor pulmonale. Some of these are:
-
Autoimmune diseases
that damage the lungs, such as
scleroderma
Autoimmune diseases
An autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 types of aut...
ImageRead Article Now Book Mark ArticleScleroderma
Scleroderma is a disease that involves the buildup of scar-like tissue in the skin and elsewhere in the body. It also damages the cells that line th...
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Chronic obstructive pulmonary disease
(COPD)
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD) is a common lung disease. Having COPD makes it hard to breathe. There are two main forms of COPD:Chroni...
ImageRead Article Now Book Mark Article - Chronic blood clots in the lungs
-
Cystic fibrosis
(CF)
Cystic fibrosis
Cystic fibrosis is a disease that causes thick, sticky mucus to build up in the lungs, digestive tract, and other areas of the body. It is one of th...
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Scarring of the lung tissue (
interstitial lung disease
)
Interstitial lung disease
Interstitial lung disease is a group of lung disorders in which the lung tissues become inflamed and then damaged.
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Severe curving of the upper part of the spine (
kyphoscoliosis
)
Kyphoscoliosis
Scoliosis is an abnormal curving of the spine. Your spine is your backbone. It runs straight down your back. Everyone's spine naturally curves a b...
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Obstructive sleep apnea
, which causes stops in breathing because of airway inflammation
Obstructive sleep apnea
Obstructive sleep apnea (OSA) is a problem in which your breathing pauses during sleep. This occurs because of narrowed or blocked airways.
ImageRead Article Now Book Mark Article - Idiopathic (no specific cause) tightening (constriction) of the blood vessels of the lungs
Symptoms
Shortness of breath or lightheadedness during activity is often the first symptom of cor pulmonale. You may also have a fast heartbeat and feel like your heart is pounding.
Over time, symptoms occur with lighter activity or even while you are at rest. Symptoms you may have are:
- Fainting spells during activity
- Chest discomfort, usually in the front of the chest
- Chest pain
- Swelling of the feet or ankles
- Symptoms of lung disorders, such as wheezing or coughing
- Bluish lips and fingers (cyanosis)
Exams and Tests
Your health care provider will perform a physical exam and ask about your symptoms. The exam may find:
- Fluid buildup in your belly
- Abnormal heart sounds
- Bluish skin
- Liver swelling
- Swelling of the neck veins, which is a sign of high pressure in the right side of the heart
- Ankle swelling
These tests may help diagnose cor pulmonale:
- Blood antibody tests
-
Blood test to check for a substance called brain natriuretic peptide (
BNP
)
BNP
Brain natriuretic peptide (BNP) test is a blood test that measures levels of a protein called BPN that is made by your heart and blood vessels. BNP ...
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Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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CT scan of the chest
, with or without an injection of a contrast fluid (dye)
CT scan of the chest
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
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Echocardiogram
Echocardiogram
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...
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ECG
ECG
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
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Lung biopsy
(rarely done)
Lung biopsy
An open lung biopsy is surgery to remove a small piece of tissue from the lung. The sample is then examined for cancer, infection, or lung disease....
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Measurement of blood oxygen by checking arterial blood gas (
ABG
)
ABG
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
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Pulmonary (lung) function tests
Pulmonary (lung) function tests
Pulmonary function tests are a group of tests that measure breathing and how well the lungs are functioning.
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Right heart catheterization
Right heart catheterization
Swan-Ganz catheterization is the passing of a thin tube (catheter) into the right side of the heart and the arteries leading to the lungs. It is don...
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Ventilation and perfusion scan of the lungs
(V/Q scan)
Ventilation and perfusion scan of the l...
A pulmonary ventilation/perfusion scan involves two nuclear scan tests to measure breathing (ventilation) and circulation (perfusion) in all areas of...
ImageRead Article Now Book Mark Article - Tests for autoimmune lung disease
Treatment
The goal of treatment is to control symptoms. It is important to treat medical problems that cause pulmonary hypertension, because they can lead to cor pulmonale.
Many treatment options are available. In general, the cause of your cor pulmonale will determine which treatment you receive.
If your provider prescribes medicines, you may take them by mouth (oral), receive them through a vein (intravenous or IV), or breathe them in (inhaled). You will be closely monitored during treatment to watch for side effects and to see how well the medicine works for you. Never stop taking your medicines without first talking to your doctor.
Other treatments may include:
- Blood thinners to reduce the risk of blood clots
-
Medicines to manage heart failure symptoms
Medicines to manage heart failure sympt...
CHF - medicines; Congestive heart failure - medicines; Cardiomyopathy - medicines; HF - medicines
Read Article Now Book Mark Article - Oxygen therapy at home
- A lung or heart-lung transplant, if medicine does not work
Important tips to follow:
- Avoid strenuous activities and heavy lifting.
- Avoid traveling to high altitudes.
- Get a yearly flu vaccine, as well as other vaccines, such as the pneumonia vaccine.
- If you smoke, stop.
- Use oxygen if your doctor prescribes it.
- Women should not get pregnant.
Outlook (Prognosis)
How well you do depends on the cause of your cor pulmonale.
As your illness gets worse, you will need to make changes to your home so that you can manage as well as possible. You will also need help around your house.
Possible Complications
Cor pulmonale may lead to:
- Life-threatening shortness of breath
- Severe fluid buildup in your body
-
Shock
Shock
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means that the cells and organs...
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When to Contact a Medical Professional
Call your provider if you have shortness of breath or chest pain.
Prevention
Do not smoke. Smoking causes lung disease, which can lead to cor pulmonale.
References
Ferri FF. Cor pulmonale. In: Ferri FF, ed. Ferri's Clinical Advisor 2016. Philadelphia, PA: Elsevier Mosby; 2016:368-370.
McLaughlin VV, Humbert M. Pulmonary hypertension. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 74.
-
Sarcoid, stage IV - chest X-ray - illustration
This film shows advanced sarcoid, scarring of the lungs (the light streaking), and cavity formation (the dark areas in the upper right side of the picture).
Sarcoid, stage IV - chest X-ray
illustration
-
Acute vs. chronic conditions - illustration
Acute conditions are severe and sudden in onset. This could describe anything from a broken bone to an asthma attack. A chronic condition, by contrast is a long-developing syndrome, such as osteoporosis or asthma. Note that osteoporosis, a chronic condition, may cause a broken bone, an acute condition. An acute asthma attack occurs in the midst of the chronic disease of asthma. Acute conditions, such as a first asthma attack, may lead to a chronic syndrome if untreated.
Acute vs. chronic conditions
illustration
-
Cor pulmonale - illustration
Chronically low blood levels of oxygen may lead to pulmonary hypertension (high blood pressure in the lungs), and possibly to cor pulmonale. Cor pulmonale is also called right-sided heart failure, and is characterized by enlargement of the right ventricle. Treatment targets the underlying illness and may include supplemental oxygen, a low-salt diet or calcium channel blockers.
Cor pulmonale
illustration
-
Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
-
Sarcoid, stage IV - chest X-ray - illustration
This film shows advanced sarcoid, scarring of the lungs (the light streaking), and cavity formation (the dark areas in the upper right side of the picture).
Sarcoid, stage IV - chest X-ray
illustration
-
Acute vs. chronic conditions - illustration
Acute conditions are severe and sudden in onset. This could describe anything from a broken bone to an asthma attack. A chronic condition, by contrast is a long-developing syndrome, such as osteoporosis or asthma. Note that osteoporosis, a chronic condition, may cause a broken bone, an acute condition. An acute asthma attack occurs in the midst of the chronic disease of asthma. Acute conditions, such as a first asthma attack, may lead to a chronic syndrome if untreated.
Acute vs. chronic conditions
illustration
-
Cor pulmonale - illustration
Chronically low blood levels of oxygen may lead to pulmonary hypertension (high blood pressure in the lungs), and possibly to cor pulmonale. Cor pulmonale is also called right-sided heart failure, and is characterized by enlargement of the right ventricle. Treatment targets the underlying illness and may include supplemental oxygen, a low-salt diet or calcium channel blockers.
Cor pulmonale
illustration
-
Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
Review Date: 1/30/2016
Reviewed By: Denis Hadjiliadis, MD, MHS, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
